You can receive a Medicare rebate for an osteopathy service if you are a patient in the Chronic Disease Management (CDM) program. You might receive a rebate for some X-rays referred by an osteopath.
Chronic Disease Management (CDM) program explained
If you need treatment for a condition that has been (or is likely to be) present for six months or longer, your GP may refer you to an osteopath as part of a Chronic Disease Management (CDM) program. There is no specific list of conditions covered under the CDM program, but treatment by an osteopath for a range of chronic musculoskeletal conditions could be covered by a CDM plan if your GP considers this appropriate.
Your GP is responsible for reviewing and revising your overall CDM care plan, even if an osteopath is involved in providing clinical care, advice and support. Your osteopath will provide reports to the GP as part of your management plan.
If your osteopath is bulk billing, you should not pay any out of pocket expense for the service. However, your osteopath may charge a ‘gap fee’, which is an amount you pay above the Medicare benefit paid to the provider. The amount varies between practices, but the practice should inform you that:
- They will not accept the Medicare benefit as full payment for your treatment
- That they will charge a gap fee, and what this charge will be
Your osteopath may process a Medicare claim for you online or via their EFTPOS terminal, or they might give you a receipt which you can submit to Medicare – either online, by post or by visiting a Department of Human Services office.
All Medicare eligible services must be at least 20 minutes long.
For more information about CDM, visit the Department of Health.
You may be able to claim a Medicare rebate for some x-rays referred by an osteopath. These include examinations of the:
- Hip joint
- Pelvic girdle
- One or more regions of the spine
Osteopaths can also refer patients for other examinations, such as x-rays of the extremities, but it is up to the imaging provider to determine how to bill the patient and Medicare in these situations if they accept these referrals. So, when referred for medical imaging, check with the imaging provider about the Medicare benefit amount and whether there are any gap fees.